decisionhealth Newsletters, Part B News - 2015 Issue 10 (October)
How to help patients pick plans during open enrollment without going too far
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Article Overview
This article explains how medical practices can support patients during Medicare and Affordable Care Act open enrollment without crossing into plan steering. It discusses the role of neutral guidance, timing and context for sharing information, the importance of accurate network and product participation details, and practical ways to communicate plan-related information to patients and staff. The piece is aimed at clinicians, office managers, and administrative teams that help patients navigate coverage choices.
Why This Topic Matters
Patients often rely on provider offices for help understanding coverage options, but inaccurate or biased plan guidance can create compliance concerns, billing problems, and loss of trust. Knowing the boundaries of permissible assistance helps practices support patients responsibly while reducing the risk of confusion about network participation and plan availability.
Article Sections
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Enrollment season overview
Introduces the open enrollment period and why patients may need help comparing coverage options. It frames the article’s focus on provider assistance and neutrality.
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Be careful how, when you share information
Discusses the need to remain neutral when offering plan-related information and the importance of staying within permitted boundaries. It also addresses general guidance for assisting patients without implying plan recommendations.
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Don’t sabotage your efforts with bad info
Focuses on the need for accurate information about accepted plans and insurance products. It also covers communication practices that help keep patients and staff informed during enrollment.
What You Will Learn
- How provider offices can support patients during enrollment periods
- Why neutrality matters when discussing coverage options
- How to present plan-related information in a patient-friendly way
- Why accurate participation and network information is important for practices
- General best practices for communicating coverage details to patients and staff
Who Should Read This
- Physicians
- Clinical practice managers
- Front office staff
- Patient navigators
- Billing and scheduling staff
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